ISSN:0025-7931    

DOI:10.1159/000194827

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:0025-7931    

DOI:10.1159/000194828

出版商:S. Karger AG    

年代:1985

数据来源: Karger

ISSN:0025-7931    

DOI:10.1159/000194829

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Whereas the anatomical changes of the bronchial circulation in response to a wide variety of congenital and acquired cardiopulmonary diseases have been well described, little is known about its functional response. There is growing evidence that the bronchial circulation plays a major role in the pathophysiology of hyperreactive airway disease. The bronchial vascular system appears to be involved in mediator transport to and from target tissues in the airway wall, in the development of airway wall edema which may contribute to airflow obstruction, and in heat and water exchange in the tracheobronchial tree. Although our current understanding of these functions is rather sketchy, enough is known to outline the contributions of the bronchial, i.e. the systemic circulation to the mechanisms of bronchial asthma.

ISSN:0025-7931    

DOI:10.1159/000194830

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Radionuclide ventriculography allows non-invasive assessment of right ventricular performance. This study has confirmed that there is a modest reduction in right ventricular ejection fraction (RVEF) in patients with chronic obstructive pulmonary disease (COPD), as compared to normal subjects. However, occult right ventricular dysfunction also becomes apparent in these patients during exercise. The change in RVEF during exercise is related to the corresponding fall in arterial oxygen saturation in patients with COPD. Oxygen improves the response of the right ventricle to exercise, although the mechanism remains unclear. Long-term oxygen therapy, in patients with respiratory failure, does not appear to have any significant effect on RVEF.

ISSN:0025-7931    

DOI:10.1159/000194831

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The follow-up of 87 patients with long-term oxygen therapy over a 3-year period revealed a mortality of 23.7% during the first year, of 37.4% after 2 years and of 45 % after 3 years, respectively. The retrospective analysis of baseline characteristics in order to evaluate the causes for early deaths showed no difference in age, lung function tests nor the degree of respiratory insufficiency documented by serial blood gas analysis between the survivors (n = 61) and the dead (n = 26). However, in the group of early deaths there was a significant increase in pulmonary hypertension (mean pulmonary arterial pressure 40.1 ± 12.0 mm Hg) compared with the survivors, who had only mild hypertension (mean pulmonary arterial pressure 29.4 ± 8.9 mm Hg). In addition there was also a lesser response in pulmonary vasodilation during oxygen breathing in the patients who died within the first 2-year period. We conclude that marked pulmonary hypertension with poor response to oxygen breathing is a major limiting factor in the prognosis of patients with long-term oxygen therapy. In contrast neither severe airway obstruction nor pronounced hypoxemia are related to early mortality and should therefore not be considered as a criterion for rapid deterioration and fatal outcome despite oxygen therap

ISSN:0025-7931    

DOI:10.1159/000194832

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Bronchoalveolar lavage (BAL) was performed in 1,188 patients suffering from sarcoidosis. After technical considerations, the authors analyze the results of BAL from a practical point of view concerning (1) its value for the diagnosis of sarcoidosis and (2) its prognostic value and its value for the selection of therapy, particularly for the decision as to steroid treatment. BAL helps in the diagnosis of sarcoidosis, but is not specific enough to provide this diagnosis on its own. The persistence of high alveolar lymphocytosis within the first year of evolution is strongly correlated with nonrecovery from pulmonary sarcoidosis at 2 years and thus with the evolution towards a chronic phase of the disease. On the other hand, BAL can provide basic information for a better understanding of the disease and permits immunocompetent cells and soluble factors to be recovered from the lung, which is useful for immunological studies.

ISSN:0025-7931    

DOI:10.1159/000194833

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

We studied the prognostic value of the initial radiologic stage, the serum-angiotensin-converting enzyme (SACE) and T helper cells in blood (OKT-4-Bl) and in bronchoalveolar lavage (OKT-4-BAL) for patients with biopsy-proven pulmonary sarcoidosis. Thirty-seven patients without prior treatment were followed up for a period of 2 years. A BAL was performed in 22 of them as part of the diagnostic workup. Clinical examination, chest radiographs, vital capacity, diffusion capacity for CO, airway resistance and PaO2 at rest and during exercise were determined initially and after 6, 12 and 24 months. According to these results, patients were classified as having progressive or nonprogressive disease. The radiologic stage and the initial SACE (38.3 ± 10.2 vs. 43.7 ± 13.0 nmol/ml/min) could not discriminate between the two groups. Patients with progressive disease had significantly fewer OKT-4-B1 cells (403.3/μl ± 146.7/μl vs. 842.0/μl ± 430.1/μl) and more OKT-4-BAL cells (24.5 ± 15.4% vs. 7.0 ± 2.6%) than patients with stable disease (p < 0.01). A negative correlation between OKT-4-Bl and OKT-4-BAL cells was shown (Rs = -0.79; p < 0.001). We conclude that the number of OKT-4-Bl and OKT-4-BAL cells can be used as prognostic parameter for patients with sa

ISSN:0025-7931    

DOI:10.1159/000194834

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The purpose of this prospective study in 66 patients with acute ischemic heart disease was to analyze the possible effects of moderately elevated levels of carboxyhemoglobin (COHb) on the early course of this disease. Thirty-one patients presented with a level of COHb ≤2% and 35 with a level of > 2%. In the group with elevated COHb, more patients developed transmural infarction, but the difference was not significant (p = 0.123). Patients with transmural infarction had higher maximum CPK values (p 2%. During the first 6 h after admission to hospital, these patients needed an antiarrhythmic treatment significantly more frequently (p = 0.003). Differences in rhythm disorders were still present at a time when nicotine, due to its short biological half-life, was already eliminated. We conclude that a moderately elevated level of COHb is not just a marker for recent smoking but may aggravate the course of acute ischemic heart diseas

ISSN:0025-7931    

DOI:10.1159/000194835

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Altered pulmonary function has been reported by many authors in hyperlipemic animals and patients. Our experiments show that isolated lungs of rats rendered hyperlipemic by means of suitable diets display a significantly increased static compliance when pressure-volume (P-V) curves are analyzed during deflation following inflation with air. No differences are observed when P-V curves are obtained with saline. Furthermore the stability index calculated through the analysis of the deflation curve was significantly higher in rats treated with two different hyperlipidic diets (average stability index: 1.06 and 1.04 in the two treated groups, both significantly higher than the two control groups, 0.80 and 0.72, p < O.Ol in both cases). The observed mechanical effects of hyperlipidemia on lung characteristics in rats show that altered surfactant properties and function play a major role in these experimental conditions.

ISSN:0025-7931    

DOI:10.1159/000194836

出版商:S. Karger AG    

年代:1985

数据来源: Karger